Multiple transferences and multifamily psychoanalysis group Luciana De Franco, Mariella Cortese, Caterina Tabasso Abstract The aim of our
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1 Multiple transferences and multifamily psychoanalysis group Luciana De Franco, Mariella Cortese, Caterina Tabasso Abstract The aim of our presentation is to explore and the aspects of Multifamily Psychoanalysis Groups (MFPG) that convey inner working-through and transformation. Such processes are considered just as they are usually depicted by the psychoanalytic theory and practice. In the specific and peculiar frame of MFPG, the raise of an emotional atmosphere facilitating the expression of the emotional charge, i.e. of the transfert, is essential. Moreover, therapeutic alliance is the basic condition for the activation of an analytic work in the group. The MFPG is typically the context of multiple transferences. Hence, making the transfert emerging clearly in front of all participants and revealing its dynamic is crucial for spreading the ability to discover the transferal feature of any relationship. This way one can travel through the path to a progressive understanding of projections and counterprojections, towards the activation of a process made up by becoming aware, focusing and discovering new resources. Key words: multiple transferences, psychological working through, emotioanl atmosphere, therapeutic alliance, psychotic transference, group, co-therapy Anybody suffering from a mental illness is not somebody who got ill as a child because something happened. It is about something happening on a daily basis. Jorge E. Garcìa Badaracco The MultiFamily Psychoanalysis Group (MFPG) allows for working through all processes described by Psychoanalysis and for getting all psychological changes implied by that work, even though in the frame of a different setting. The presence in person of the people with whom patients are bonded with allows for the arise by use of the direct and in person dialogues in the group- of the dynamic that happens day in day out among people living together. At the same time, it is also possible to detect the presence and the actualization of primitive intrapsychic conflicts that tend to repeat. In such a new context (MFPG) everything we have described above can be considered as similar to what in a psychoanalytical individual setting the patient tells the analyst. Hence, it is the strength of such context, together with the repetition of intrapsychic conflicts that allows for expressing the emotional load, i.e. the transference. 1
2 In our experience, the main catalyzing factor for the group s ability to show and understand the dynamics of transference is the emotional atmosphere. Thanks to the specific emotional atmosphere of the group, participants drop their fear of emotional involvement, and begin to check out the group experience. The group s transformative power can be assessed in proportion to the quality of such emotional atmosphere. Additionally, therapeutic alliance is also an essential condition for a chance of psychoanalytical working through to be activated in the group. One of the strongest suggestions to the therapist given by J. Garcìa Badaracco s theory is to point out positive aspects of patients. An element that facilitates building up the therapeutic alliance is indeed the therapist identifying with the group participants. Identification allows the therapist to sense each participant s difficulties and support the patient s ego. Pointing out the participants positive aspects encourages a positive participation that leads to a specific utilization of the group by those talking part into it. Such utilization is intended as experiencing, a concept close to that of the emotional intelligence, as it enables to continuously generate new resources for the Ego. The therapeutic alliance developed in the frame of the multifamily group is also necessary in order to contain the psychotic transference, that is often characterized by highly violent contents. Facilitating the containment of acting out, therapeutic alliance enables the patient to experiment and to experience more. The repetition that is pointed out through transference leads to look at the relationship as a neverending mechanism. On one hand repetition implies automatic procedures (one cannot choose) aimed at obtaining always the same results, on the other it is known that repetition implies by its nature an attempt to overcome something that has not found a solution yet. Going back to the psychoanalytical working through, we know that often the sole awareness about the conflict is not enough for the structuring of new situations. It is necessary that a whole process gets activated. This is something that in the individual setting happens by means of the analyst analyzing the transference. In a MFPG, characterized by multiple transferences, what is crucial in such regard is pointing out the transference phenomenon to all participants. Revealing the transference in the context of a MFPG is useful in order to develop the collective ability to understand the transference value of each relationship. Therefore progressing towards the comprehension of projections and counter-projections becomes possible. In other words, it is possible to activate the essential process of becoming aware, focusing and activating resources. When in the group, while observing a conflict, the therapist comes into play as a third mediating part, this sets free the people involved in the conflict, and 2
3 operates a significant and shared movement that activates the process described above. In order to better explore it, we propose to divide such process in the following steps: becoming aware ->generates new Ego resources -> a new focus is available for the subject -> the subject s perspective is widened and generalized to other, new situations -> other new Ego resources are available. A clinical example will clarify our idea Raimondo, Luca s father, arrives at the group on his own, and after a few sessions his wife catches up with him at the group. The topic Raimondo tells the group most intensely is his being upset about his son Luca. In Raimondo s opinion, Luca could do much more. Raimondo thinks that Luca, who is in his thirties and has been diagnosed with schizophrenia, is a gifted young man who s not doing enough for his own wellbeing. Raimondo s transference movements during the first sessions he attends are mainly addressed to the therapists team and to those among the participants who encourage him towards a more positive attitude in identifying and recognizing emotions in the relationship with his son. In a following phase Raimondo detects in Stefania, another participant, a possible embodiement of Luca. Stefania is 38 and suffers from recurrent depression since she was 16. The dominant topic of her statements in the group is that of the invincibility of her disease, and the power that this exerts on her. At first, Raimondo tends to be aggressive towards Stefania, as her helplessness seems to annoy him. Raimondo seems to be identifying with Stefania s whole family, that attends the group but does not seem able to get depressed enough and hence converts its sense of helplessness into rage against Stefania. Raimondo as well is unable to develop a depressive thought, to think they can t make it as he is unable to think it of himself. This is why during a group session Raimondo addresses Stefania using the plural, clearly including his son while expressing his thoughts, asking her: Why can t you guys make it? What exactly prevents you from making it? Stefania gets very sad, and she seems on the verge of tears. She almost leaves the group when she answers I can t make it because because I am worthless! Confronted with Raimondo s rage and the excess of responsibility on Stefania s shoulders, one of the therapists steps in saying: Stefania is just one! She cannot be responsible for her whole family feeling helplessness! 3
4 As a consequence of such intervention the tension eases: all participants can identify with Stefania who got helped out and also with the helping therapist. In the following sessions, Riamondo keeps on the dialogue with Stefania. He then appears to be moving along a double track, as he becomes able to get in touch with his son s less acceptable parts, but also with his own depressed side. With time passing his tone changes and when he talks to Stefania his statements are very careful and feature new emotions, in particular when Stefania is back to the group after having been in hospital for a planned admission. Together with these events, significative improvements happen in the relationship between Raimondo and his son Luca, that becomes franker and more open to recognizing each other s needs. Taking part, for the patient-character, directly and in person in a safe context (safe thanks to the therapeutic alliance) into the representation of his/her own inner theatre (multiple tranferences), and being at the same time able to identify with other characters who are helped our and who are helping others, who are strong and weak at the same time, allows for getting in touch with one s ambivalency. Such process happens while feeling held and supported by a safe hand that allows the patient to open up to new positive experiences. The therapist s intervention is clearly effective if and when the therapist is able to give up those power shades that are brought about by narcissistic gratifications. This is possible if the therapist has developed a strong enough inner setting that allows him/her to include countertransference phenomena into his/her work. In order to summarize everything we have described so far, we would like to stress that activation and processing of multiple transferences in the multifamily field relies on the following premises: - committed participation - specific emotional atmosphere - possibility to point out the patient s positive features by use of identification Multiple transferences, therapeutic alliance and co-therapy The co-therapist function is an essential one when it comes to support the patient s Ego. Starting from his/her countertransference perceptions, the co-therapist detects the lack of resources the patient seems to be suffering from in a specific moment, and he/she promptly points that out. Such move is intended in favour of the maintenance of the therapeutic alliance, which in turn is crucial to the continuation of therapy. 4
5 We would like to mention at this point that the psychotic transference is characterized by the presence of strongly emotional elements. Repetition, after all, implies that the pathogenic relationship activates a never-ending reiteration mechanism. As we already mentioned, on the one hand repetition is the result of automatisms, as it does not implies a choice, on the other aims to the very overcoming of such mechanism (that is well depicted in Pan s myth). Such aspects are relevant as in the clinical practice transference appears as a multiple phenomenon, with multiple shapes and layers. On the one hand it has an infantile-repetitive nature, but on the other it indeed contains unconscious aspects of the personality that seek for expression. As far as those aspects are projected out, they are embodied by the other. In MFPG transference phenomena are indeed considered as a potential for transformation just because of them implying moving, transferring and changing the value and the sense of unconscious aspects seeking for listening, expansion, translation and, above all, meaning and integration. Besides old stuff (repetition compulsion) something new comes to light. In this regard, we would like to add that Jung, as Freud s pupil and contemporary scholar, was the first to apply psychoanalytic method to psychosis. He considered regression and transference with a double perspective: as something that tends to go back to the origins and to an undifferentiated state, and as a way to express and disclose one s unknown parts. Jung wrote: Transference refers to an unconscious activated element that seeks expression. The transference intensity corresponds to the importance of the projected content. A strong, violent transference contains something of true importance, bearing a great value to the patient, and analysis cannot be considered done until such value is not integrated (C.G.Jung, The Fundamentals of Analytical Psychology,1935, vol. XV). Hence, the activation of multiple transferences as they arise in the MFPG allows to get closer and deeper in repetitions. Repetitions are responsible for the conservation of pathological bonds in pathological interdependency. This in turn keeps the Ego lack of resources unaltered. But getting closer and deeper into repetitions allows also for detecting that vital, silent core that could not develop in the past and is now seeking for expression. Pathogenic identifications keep the patient in his/her own role as a specific character, and this is how he/she introduces him/herself to the group. Such character implies a high degree of psychological pain, though staying in the character seems less risky than facing a change. In MFPG both the emotional atmosphere and the specific style therapists have in conducting the session allow for detecting, supporting and organizing participants 5
6 experiences. In such frame, multiple transferences can be considered as tools for the beginning, Deo concedente, of the process of becoming conscious (through activating Ego resources, focusing, and reactivating) we mentioned before. Such process brings about the deep experience of staying active, while tolerating both conflict and the structural passivity typical of any human being. This in turn leads to develop a new relational manner grounded on a frustration-gratification register. In such perspective MFPG is the context that more than any other allows for the most severe regressions and for the craziest expression of a human being. To our experience, there is no other context having a comparable therapeutic ability as such. In a MFPG transference is worked through in order to make it visible and to actualize it. At the same time the conditions for each participant to gain a new psychological functioning are provided. The new functioning is intended as one that encourages to detect both one s own transference and the other s transference, and to understand that this happens in any relationship. We believe that such discovery lays the foundations for the development of essential analytical abilities, such as self-observation and self-reflection. References Badaracco, J.G. (2000) Psicoanalisi Multifamiliare. Torino: Bollati Boringhieri, Jung,C.G. (1935) Fondamenti della Psicologia Analitica, in Opere vol. XV, Torino: Bollati Boringhieri, Luciana De Franco: Psychologist, teacher of the association Italian Analytical Psychology and IAAP, founder of the Circle of Promotion Social Endless Angles, President of the LIPsiM - Laboratory Italian Psychoanalysis Multifamiliare. luzdef@tiscalinet.it Caterina Tabasso: MA in Jungian and Post-Jungian Studies, Psychologist, member of the association Italian Analytical Psychology and IAAP, founder of the Circle of Promotion Social Endless Angles, Full member of the LIPsiM - Laboratory Italian Psychoanalysis Multifamiliare. ctabasso@yahoo.com Mariella Cortese: Psychologist, member of the association Italian Analytical Psychology and IAAP, co-founder of the Circle of Promotion Social Endless Angles. mari18@tiscali.it 6
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